水悬浮下双尼龙绳套扎联合高频电切治疗结肠粗蒂息肉

Underwater endoscopic resection by double nylon endoloop combination with high-frequency electric snare for the treatment of thick-pedunculated colorectal polyps

摘要:

目的 探讨内镜水下双尼龙绳套扎联合高频电切治疗结肠粗蒂息肉的可行性。方法 回顾性研究2017年1月－2018年6月复旦大学附属中山医院内镜水悬浮下双尼龙绳套扎联合高频电切治疗的43例结肠粗蒂息肉患者的临床资料。观察患者术后有无出血等并发症发生；随访观察患者有无迟发性出血发生。结果 43例患者共成功切除43枚结肠粗蒂息肉，息肉最大直径1.0～3.5 cm，平均2.7 cm；息肉蒂部直径0.5～1.5 cm，平均1.1 cm；内镜下手术时间5～16 min，平均9.2 min。肠腔内灌注水量120～750 mL，平均330 mL。尼龙绳套扎次数1至2次，平均1.1次，尼龙绳一次套扎成功率95.4%（41/43）。息肉完整切除率100.0%，整块切除率100.0%，患者息肉切除治疗有效率为100.0%。43枚息肉经病理检查证实为腺瘤性息肉。无1例患者术中出血；随访期间无1例患者发生迟发性出血。结论 内镜水悬浮下双尼龙绳套扎联合高频电切治疗结肠粗蒂息肉，是安全可行的。

Abstract:

Objective To evaluate the clinical feasibility of underwater endoscopic resection by double nylon endoloop combination with high-frequency electric snare for the treatment of thick-pedunculated colorectal polyps.Methods In our study, 43 patients with colorectal polyps with thick stalk underwent underwater endoscopic resection of double endoloop combination with high-frequency electric snare were included from January 2017 to June 2018. Resected tumor size, procedure time, en-bloc resection rate and complication rate were collected and analyzed.Results The median tumor size (cm) was 2.7 cm (1.0～3.5 cm), pedicle average diameter(cm) was 0.9 cm (0.5～1.5 cm); The procedure time (min) was 9.2 min (5～16 min). The total volume of water was 330 mL (120～750 mL). The number of nylon rope ligation times was 1.1 times (1～2 times). The success rate of nylon rope was 95.4% (41/43). The success rate of nylon rope was 100.0%. The complete resection rate was 100.0%, the en-bloc resection rate was 100.0%. 43 polyps confirmed adenomatous by pathological examination. None of the patients had bleeding in the operation. No delayed bleeding occurred during follow-up.Conclusion Underwater endoscopic resection of colorectal polyps with thick stalk by double nylon endoloop combination with high-frequency electric snare has a short procedure time and low complication rate. So it is an effective and feasible therapy for colorectal polyps with thick stalk.